Outcomes of genetic testing in adults with a history of venous thromboembolism

prepared for Agency for Healthcare Research and Quality ; prepared by The Johns Hopkins University Evidence-based Practice Center ; investigators, Jodi B. Segal ... [et al.]."June 2009."This report was requested and funded by the Centers for Disease Control and Prevention (CDC), Office of Public Health Genomics (OPHG).Includes bibliographical references (p. 91-98)

Guidance on the Cleanup, Temporary or Intermediate Storage, and Transport of Mercury Waste from Healthcare Facilities

The UNDP GEF project involves demonstrating best practices for the management of mercury waste and promoting mercury-free devices. As health facilities phase out mercury devices, proper methods of storage and transport are needed. This document is intended for project countries where national norms and guidelines for cleanup, storage, and transport of mercury waste do not exist at this time. These suggested guidelines should become part of a broader plan for sequestration and phase-out of mercury

A Return to Virtue

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75581/1/j.1553-2712.2008.00309.x.pd

Changes in the use of coronary artery revascularization procedures in the Department of Veterans Affairs, the National Hospital Discharge Survey, and the Nationwide Inpatient Sample, 1991–1999

BACKGROUND: There have been dramatic increases in the number of coronary artery bypass surgeries (CABS) and percutaneous coronary interventions (PCI) performed during the last decade. Whether this finding is true for revascularization procedures performed in Department of Veterans Affairs (VA) medical centers is the subject of this paper. METHODS: This study compared the number of revascularization procedures and rates of use in the VA, the National Hospital Discharge Survey, and the Nationwide Inpatient Sample. Included were men who underwent isolated CABS and/or PCI, including stenting, between 1991 and 1999, although data for the Nationwide Inpatient Sample were available only between 1993 and 1997. Age adjusted use rates were calculated with the direct method of standardization. RESULTS: The percent of users of VA healthcare 75 years and older increased from 10% in 1991 to 20% in 1999. In the VA, the number of isolated CABS declined from 6227 in 1991 to 6147 in 1999, whereas age adjusted rates declined from 167.6 per 100,000 in 1991 to 107.9 per 100,000 in 1999. In the 2 national surveys, both the estimated numbers of procedures and use rates increased over time. In all 3 settings, there were increases in both numbers and rate of PCI from 1993, although in the VA, use rates decreased from 191.2 per 100,000 in 1996 to 139.7 per 100,000 in 1999. VA use rates for both CABS and PCI were lower than those in the 2 national surveys. CONCLUSION: Age adjusted rates of CABS and PCI were lower in the VA than in 2 national surveys. Since 1996, there has been a decrease in the rate of use of revascularization procedures in the VA

Permeation of Herbicidal Dichlobenil From a Casoron Formulation Through Nitrile Gloves

The aim of this study was to measure permeation of the herbicide dichlobenil in Casoron 4G through disposable and chemically protective nitrile gloves using an American Society for Testing and Materials-type permeation cell and a closed-loop system employing two different solvents (hexane and water) and two different challenge situations (aqueous emulsion and solid formulation). Capillary gas chromatography–mass spectrometry was used for quantification purposes. The chemically protective glove did not allow any permeation up to 8 h for the solid-formulation and water-collection challenges, but permeation was detected in all other challenges. The disposable glove allowed the most permeation, and the solid-formulation challenge with water collection necessitated that a dichlobenil equivalent be calculated because of the presence of its hydrolysis degradation product 2,6-dichlorobenzamide. Permeation from the solid formulation was detectable by hexane collection for both the disposable and chemically protective gloves and by water collection for the disposable glove. It was concluded that hexane-solvent collection was not valid for the disposable glove at 4 and 8 h of permeation in the solid Casoron challenge or for the aqueous emulsion challenge at 8 h relative to the water-collection solvent data. The hexane-solvent collection for the chemically protective glove was valid for the 8-h solid-formulation challenge but not for the 8-h aqueous-solution challenge. All water-solvent collections were valid; however, dichlobenil usually permeated the gloves

Drinking behaviour and alcohol-related harm amongst older adults: analysis of existing UK datasets.

Older adults experience age-related physiological changes that increase sensitivity and decrease tolerance to alcohol and there are a number of age-related harms such as falls, social isolation and elder abuse, which are compounded by alcohol misuse. Despite this unique vulnerability and the fact that the number of older adults is increasing, the literature on drinking behaviour and alcohol-related harm in older adults is sparse. This article describes a secondary analysis of UK data to address this knowledge gap

Emergency Medical Practice: Advancing Cultural Competence and Reducing Health Care Disparities

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72132/1/j.1553-2712.2008.00305.x.pd

Safety Culture in the Maternity Units: a census survey using the Safety Attitudes Questionnaire

Background: Patient safety has been a priority for many societies and health care systems in the last decades. Identification of preventable risks and aversion of potentially unsafe situations and fatal complications in maternity units is life saving. The explicit need to focus on quality of care underpins the aim of the study to initially evaluate the safety culture and teamwork climate in the public Maternity Units of the 5 Regional Hospitals in Cyprus as measured by a validated safety attitudes tool. Methods. Data were collected from 140 midwives working in the public sector all over Cyprus by the Greek Version of the Safety Attitudes Questionnaire-Labor version. Results: One hundred and six (75.71%) registered midwives completed the questionnaire fully. The median of total work experience as a registered midwife was 3 years (IQR: 2-18.25); whereas the median of total working experience in the nursing and maternity units was 5 years (IQR: 2-21.75). Experienced midwives rated the following domains higher: team work, safety climate, job satisfaction and working conditions as opposed to the midwives with less experience. Additionally those with a longer working life in the current maternity units rated these domains higher: safety climate, job satisfaction and working conditions as opposed to the less experienced midwives. Conclusions: The high mean total score on team work and safety climate in the more experienced group of midwives is a predominant finding for the maternity units of Cyprus. In Cyprus where facilities are small in size and midwives know each other, share more responsibility towards patient safety. It could be suggested that younger midwives need more support and teamwork practice to enhance the safety and teamwork climate towards self-confidence

Employer Health Insurance Mandates and the Risk of Unemployment

Employer health insurance mandates form the basis of many health care reform proposals. Proponents make the case that they will increase insurance, while opponents raise the concern that low-wage workers will see offsetting reductions in their wages and that in the presence of minimum wage laws some of the lowest wage workers will become unemployed. We construct an estimate of the number of workers whose wages are so close to the minimum wage that they cannot be lowered to absorb the cost of health insurance, using detailed data on wages, health insurance, and demographics from the Current Population Survey (CPS). We find that 33 percent of uninsured workers earn within $3 of the minimum wage, putting them at risk of unemployment if their employers were required to offer insurance. Assuming an elasticity of employment with respect to minimum wage increase of -0.10, we estimate that 0.2 percent of all full-time workers and 1.4 percent of uninsured full-time workers would lose their jobs because of a health insurance mandate. Workers who would lose their jobs are disproportionately likely to be high school dropouts, minority, and female. This risk of unemployment should be a crucial component in the evaluation of both the effectiveness and distributional implications of these policies relative to alternatives such as tax credits, Medicaid expansions, and individual mandates, and their broader effects on the well-being of low-wage workers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73099/1/j.1540-6296.2008.00133.x.pd